[unreadable] The objective of this research is to develop an expert visual guidance system to direct rural health care providers (HCP) in acquiring diagnostic medical ultrasound images. The system does not just passively transmit images to an expert in a distant medical center: it will enable the expert to actively guide the HCP in acquiring images. The expert will provide this guidance through a visual and anatomic interface, one that we hypothesize will be more efficient than verbal instructions alone. The rationale is that assistance must be provided at acquisition; otherwise the expert at the receiving end of a telemedicine link may have difficulty interpreting studies because of their poor diagnostic quality. This project builds a visual guidance system that we built for NASA to assist flight personnel acquire medical ultrasound images on each other aboard the International Space Station. This project also builds on our experience in teletrauma to provide 24-hr support to rural emergency room physicians for the care of injured patients from the Level 1 trauma center specialists. Specific Aim #1 is to develop the hardware and software for a remote expert guidance system that will enable an expert in another location to remotely direct a HCP during scanning of live subjects. Specific Aim #2 is to test the system's performance by evaluating whether remote expert guidance is effective in directing minimally trained observers in acquiring ultrasound scans of targeted organs. Specific Aim #3 is further validation of expert visual guidance by testing whether it can improve the efficiency of a teleconsultation by enabling a remote expert to direct a rural HCP in acquiring images in a shorter time than verbal instruction alone. Specific Aim #4 is to make the guidance easily applicable to different organs. [unreadable] [unreadable]